Abstract
INTRODUCTION: Diabetes mellitus (DM) in cats imposes significant caregiver burdens, with 20% of all diabetic cats reportedly dead ≤ 30 days after diagnosis. Risk factors for cats not receiving anti-hyperglycemic therapy (AHT) are unreported. Studies evaluating early mortality in cats with DM who receive AHT are limited.
OBJECTIVES/HYPOTHESIS: Report risk factors for diabetic cats failing to receive AHT, and analyze factors associated with mortality ≤ 30 days following DM diagnosis in cats starting AHT.
ANIMALS: 375 cats under United Kingdom primary veterinary care with a first lifetime diagnosis of DM in 2019.
METHODS: Anonymized retrospective cohort study using electronic health records from VetCompass. Multivariable logistic regression and Cox proportional hazards models were performed, including risk factors (p < 0.2) associated with cats not receiving AHT and ≤ 30-day mortality when receiving AHT, respectively.
RESULTS: Exactly 65/375 (17.3%) diabetic cats did not receive AHT. In cats that started AHT (n = 310), estimated ≤ 30-day mortality was 10.0% (95% CI 7.1–13.8). Cats ≥ 15.0 years had significantly increased odds of not receiving AHT (OR 2.6 [95% CI 1.1–6.0], p = 0.024) (Table 1) and also increased ≤ 30-day mortality hazard after starting AHT (HR 3.5 [95% CI 1.2–10.1], p = 0.019) (Table 2). Presenting clinical signs and co-morbidities were not associated with ≤ 30-day mortality (p > 0.05).
CONCLUSIONS AND CLINICAL IMPORTANCE: In this population, almost 20% of diabetic cats were untreated, and greater age was a risk factor for failure to receive AHT and increased ≤ 30-day mortality. These results provide benchmarking information to assess whether outcomes change following the introduction of sodium-glucose cotransporter-2 inhibitors as treatments for feline DM.
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